So what is my problem?

nightmare, RN · Jun 24, 2007

Woh sounds like you having a rough time!How many residents do you have per unit?It must be tough trying to do med passes for a lot of unfamiliar residents if you are constantly on different units and don't get to know the people. One thing strikes me, and this is just from personal experience, just because someone "Does that" i.e being sick etc doesn't mean there is nothing wrong. Go and check even for only a minute ,keep yourself right.

Get into the habit of verbally asking at changeover "Is there any new residents?"again to keep yourself right.

Personally I would go off my head if someone was following me about looking for faults!It would make me really nervous and I 'd probably tell them to back off!

I think you need to talk to supervisor about this and try and clear the air a bit,good luck!

UM Review RN, ASN, RN · Jun 24, 2007

My union rep and coworker both say it's because I'm new - I live in a very small area, and half of the nurses have relatives in the facility - like their mothers.
This is (edited for privacy) what I wrote my rep, who said I should just put it down for her.
Tell me if it's me. Please.
I don’t know where to start.
I have been picking up a lot of extra days because I know the facility is having a hard time hiring enough nurses. Well, every time I end up on another unit a med error happens.
I still haven’t had a 90 day review and I swear it’s because MyChargeNurse is trying to figure out how to give me a lousy one with no reason to. As an example, some weeks ago she told me she was uncomfortable with my performance and couldn’t pinpoint why. I asked her for an example and she couldn’t think of one. “Safety” was her vague answer. Well, a couple of weeks ago a resident was puking and an aide told me about it. I charted on it and nothing more because, the last time this same resident was puking and I told MCN her answer was, “She does that.” No intervention, nothing. She told me later that she was waiting to see if I went to her. I guess it’s safety when she overhears me being told but not when I tell her.
I had a rash of med errors and figured out what I was doing wrong. Those are still haunting me – and happened after I should have had my review.
Ystdy I was on X and NotMyUsualChargeNurse was really on my back. I made an error – there was a new resident whom I didn’t even know existed. The nurses hadn’t updated their “cheat sheets” and her room was still showing as empty. I go through my MAR after each pass but had no time to ystdy and every time I breathed NMUCN had something for me to do. Order meds, talk to a resident – keep her occupied – swear to God. No time. Later that day I told NMUCN I hadn’t had time to do something and she told me I did. She was rude to me all day. At one point I went to say something and she cut me off saying, “I am a supervising nurse and this needs to be done.” Huh? I wasn’t arguing.
Well, I told Scheduler, and I mean it, that I will no longer accept assignment to X. This morning I went to fill out the med error and WeekendChargeNurse was there. I told her that I wouldn’t work for NMUCN and she told me I couldn’t pick and choose. I told her that I didn’t need to be made to feel incompetent every time I covered. She was silent, so I urged her to tell me what she thought. She told me that I should be further along than I am. For example, AnotherNewLPN has been here less time but she feels like she’s been here forever. I pointed out that ANLPN was working per diem for a long time before I started, and found out later ANLPN also worked here as an aide for years. So she HAS been here longer. And as soon as I got there WCN says to UnitXLPN, the usual unit X LPN, “Do you have her other med errors?” UXLPN said, “She didn’t have any others.” “Oh, no? I saw another.” I said, “Yes, AUsualCoWorker wrote me up for an error that didn’t happen. I just proved it in the MAR and wrote a note to MUCN.” What the heck?!
Anyway. I saw written on my review “meds – resident y incident.” I have no idea what that is unless it’s that some aides told NMUCN that I tried to get her up before being assessed by an RN. That’s not true. I asked her to grasp my hands so I could check for grip, and I also ASKED the aides, “Do we wait for an RN to get her up?” How that got translated into my trying to get her up I don’t know.
I’m disgusted. And I am no longer working per diem. I need the time to study so I can become an RN more quickly because I can’t stand this. And I will not work for NMUCN.

It looks like someone doesn't want you there, Sue, and they're trying to hurt you by penalizing you for everything instead of teaching you how to improve. It's happened to me too, pretty much the same way.

I found out what was really going on eventually.

What really happened was that Corporate had gotten rid of a popular RN. She promptly got another job. When the facility then tried to hire her back, she was understandably nervous as well as engaged at the new job. Oh yeah, and a couple of nurses were ticked off that I had the audacity to clean up and rearrange the Med Cart.

:trout: Well, pardon the heck outta me!

She ultimately accepted. Inside of a month, I was canned. I wasn't even mad about it.

You know why?

They all got what they wanted, and I moved on to a much better place.

You will too. So turn in your resignation and let the cards fall where they may. You've learned something very important and you'll improve as you go along.

Ironically, I had to visit a friend in that same facility just a month ago. And guess who was no longer there anymore? All of the nurses who wanted Ms. X so badly that they'd try to fry my butt to get her back. Meantime, as I said, I'd moved onward and upward and way past all that petty junk, and it wasn't the first time that I was glad I didn't stay there.

SuesquatchRN, BSN, RN · Jun 28, 2007

Well.

I'm on warning. Med errors.

First off, the DON has a concern. Remember I mentioned the womn who fell? Ended up with a C2 fracture? Two CNA's have WRITTEN that I said, "Go ahead and get her up. It's okay, I'm a nurse." Good Lord. Even when I wasn't a nurse I knew better than that.

I basically had a meltdown in her office. She does, at this point, understand a few things that are troublesome, like asshat charge nurses and having seven in a week, and that I feel very badly that I am being reamed for having told on myself for the most egregious of the med errors when I could have gotten away with it.

So.

I was given the rest of the day and tomorrow off, and I'm scheduled for Tuesday.

I stopped off at my best friend from nursing school's house and collapsed sobbing into her arms. She says it isn't me.

My DON said, "It doesn't sound like you're too happy being a nurse." I told her that I hate being an LPN, that a trained chimpanzee can do what I am permitted to do. And. I. Hate. It. So we know where we stand.

I've been weeping and floating in the pool for a while but the sun went in.

I had already told them I wouldn't be picking up any PRN days, so that's solved since my med errors are always on a unit I haven't worked in a month. And I am focusing on not getting fired so we can keep our medical benefits - my friends across the pond, be grateful for the National Health - and passing my RN boards. If I push and I'm not doing extra days I can do this, excluding clinicals, by October.

I was picking up extra days not so much because we needed the money - I prefer having the time - but because we're always short staffed. HA! As someone here's signature line reads, "Your staffing problem is not mine."

Oh, med errors here are caught and written up ny one's sister nurses. I haven't written up a med error yet and I';ve caught them. I alwaus thought it more effective to say, "BTW, X gets a phoslo at 10:30 and a Renagel at 12. You missed those ystdu." That, to me, is a learning tool. Writing someone up is punitive.

I dunno., Maybe I'm nuts. I thought we were supposed to work together.

SuesquatchRN, BSN, RN · Jun 28, 2007

Oh, and another nurse is saying bye-bye, bedside. I have a teaching job lined up as soon as I have my RN.

Not even in it a year,

nightmare, RN · Jun 28, 2007

My advice,get your RN and start passing on your good,caring attitude to students who will hopefully benefit from it and take it with them in their nursing careers.

LPN01112005 · Jun 29, 2007

Med errors are serious and you will continue to make them if you are doing med pass by a cheat sheet. You MUST use your MAR. It sounds to me like you just need to "start over" doing it the right way. Sure, it'll take a bit longer, but after a while, you'll get the hang of it and you'll become more proficient time wise.

Another thing about charting: If you are not going to chart your intervention, then you don't need to chart the problem because it appears you did nothing to intervene. FYI, if someone is vomiting, you intervention can be offering an ice pack and a emesis bag and following up after a few minutes. Or, if they have some phenergan ordered, you can give them a dose and then chart that you gave it and then chart effectiveness.

Nursing is not easy, and it can be overwhelming for a new nurse. It is unfortunate that you were given pointers on how to cut corners (cheat sheets for med pass). Whomever gave you the pointers did you a grave disservice and the DON should be made aware that this is what is going on with the new hires in her facility.

SuesquatchRN, BSN, RN · Jun 29, 2007

Med errors are serious and you will continue to make them if you are doing med pass by a cheat sheet. You MUST use your MAR.

I do use the MAR. I use the sheet simply as a base for times, but I go through it after every pass. And ystdy's shift entailed 7.

LPN01112005 · Jul 9, 2007

7 what? med omissions? I'm confused. You can't be effective with your med pass until you are using your MAR as you go along. Once you get the hang of your med pass, and have a routine going then you can skim over your MAR at the beginning of your shift for any new orders so that they will be fresh on your mind in case you go on "auto pilot" and start giving out meds by memory.

Not trying to be tough here, but if you are looking for a solution to med errors, there is only one.........Give meds by your MAR. As far as nurses writing other nurses up for med errors, I don't see how that can be conducive to a good work environment. That should be the RN Charge Nurse's job or the DON's job. I'd think it was your job to simply point out omissions to your co-worker so they can circle the med as not given. I'd question the agenda of nurses who run heat on their co-workers. What's their motivation?

egglady, LPN · Jul 13, 2007

You said you hate being an LPN and that a trained chimpanze could do what you do. So, maybe your attitude is the problem?

SuesquatchRN, BSN, RN · Jul 16, 2007

7 what? med omissions? I'm confused. You can't be effective with your med pass until you are using your MAR as you go along. Once you get the hang of your med pass, and have a routine going then you can skim over your MAR at the beginning of your shift for any new orders so that they will be fresh on your mind in case you go on "auto pilot" and start giving out meds by memory.
Not trying to be tough here, but if you are looking for a solution to med errors, there is only one.........Give meds by your MAR. As far as nurses writing other nurses up for med errors, I don't see how that can be conducive to a good work environment. That should be the RN Charge Nurse's job or the DON's job. I'd think it was your job to simply point out omissions to your co-worker so they can circle the med as not given. I'd question the agenda of nurses who run heat on their co-workers. What's their motivation?

Seven med passes. Dialysis, residents going on an outing, residents going to the clinic.... Meds timed for 7, 8, 9, 10:30, 11, 11:30, 12, 1, 2. Okay, nine passes.

I think that you are missing the point about my dispensing meds via "cheat sheet." All that does is cue me as to who is in what room and at what time they get meds. That's it. And I know my meds inside out on my own unit. I am talking about being floated to one on which I have not done meds in weeks. I am religious about NOT giving meds by memory.

The facility policy is that the coworkers write one another up. And yeah, it's a lousy method.

egglady, can we say, "Vent"?

Anyway. I got my review and it was actually favorable.

nightmare, RN · Jul 16, 2007

Glad you got a good review,Sue and hope things settle down for you.